Breast Augmentation: Cost, Reviews, Photos

There are several factors which determine the height of the nipple/areola following a lift.

In most cases, the nipple is positioned too low but it can also be raised too much.

When this happens, although it can be fixed, the solution is not that easy.

One option would be to remove a wedge of tissue from the base of your breast and essentially bring down the nipple to a lower position on the breast mound itself.

This would also reduce the distance from the fold to the nipple and so there needs to be a reasonable distance there before actually attempting this procedure. (Gregory A. Buford, MD, FACS, Denver Plastic Surgeon)

The causes of over descended implants and nipple areola complex malposition are many: too large an implant, thin skin envelope, miscalculation of amount of lift, surgical disruption of the inframammary fold, etc.

It is difficult to drop the position of the nipple after it has over lifted. One common method for fixing the problem is to decrease the size of the implant and reduce the size of the over-stretched capsule internally.

This moves the position of the implant higher on the chest allowing for better centering of the implant under the nipple areolar complex.

Another option is to remove the horizontal excess of skin and capsule at the inframammary fold to force the implant upwards. This does leave an external scar that typically fades nicely with time. I have used the latter approach successfully on several patients and the scar has not been a problem since it is typically hidden at the inframammary fold. (Manish H. Shah, MD, FACS, Denver Plastic Surgeon)

Proper nipple/areola placement in breast surgery

Combining breast augmentation and breast lift is a rather formidable procedure. The surgeon needs to be well trained, experienced and talented to execute this procedure successfully. Your condition is difficult, but not impossible to correct. It could be possible to reposition your implants higher, so that your areola complex is more centered. On the other hand either partial or full revision of your breast lift will need to be done. As I said, it is a complex problem to correct , make sure your surgeon has created a well thought out plan, and is able to execute it well. (Boris M. Ackerman, MD, Newport Beach Plastic Surgeon)

Areolas too high after breast augmentation

Having the nipple/areolas too high after a breast lift is a difficult problem to correct. However, because you have implants, there is the possibility of decreasing the size of the implants to help rotate the nipples down into a more normal position. This may or may not be combined with removal of skin below the areolas. Another option involves an ‘S’ flap where the skin from below the areola is transposed with nipple/areola such that they switch position. The problem with this approach is the necessity of placing scars on the breast which may also be visible in certain tops. (David Bogue, MD, Boca Raton Plastic Surgeon)

Lowering the areola after a breast lift (mastopexy) and breast implant (Mastopexy Augmentation) is a difficult problem, however you may consider making the aerola smaller which may make things appear improved.

I would suggest a consultation with measurements to determine if the nipple is too high or if just the areola are too big. Making the areola smaller may be easier now that your skin has stretched and healed, however if the nipple is too high, an upper breast incision may have to be used to bring things down, or down-sizing your breast impanls could help. (Andrew P. Trussler, MD, Austin Plastic Surgeon)

Areola is Too High After Breast Augmentation/ Lift

This is know as star gazing. The nipple areolar complex should be 2 cm above the Inferior mammary fold which is at the bottom of the breast attachment into the chest wall. There are several reasons: Too low of an implant, too narrow of an implant, too much skin on the lower pole of the breast.

After full evaluation a surgeon can determine what is needed. Excision of lower pole skin might be necessary with possible combination of recreation of the pocket. (Tarick K. Smaili, MD, Beverly Hills Plastic Surgeon)

If your implants appear too high, it may in fact be because the rest of your breast is disproportionally low.

There may be several ways to improve your breast appearance, so I would recommend a visit to a plastic surgeon so you can be examined get a first hand answer. (Adam David Lowenstein, MD, FACS, Santa Barbara Plastic Surgeon)

Lowering implants  is one of the most difficult things to do when the implant is too high.

There are two options. One would revise the position of the nipple and create a scar above it (closing the hole that is left behind from moving it downward).

The other option might be to raise the fold underneath your breast so the nipple does not appear to be too low.

This may be the best choice, but depends upon the current shape of your breasts and the position of the implants. If you posted some pics you might get better, more specific advice. Feel free to email me if you would like to discuss this further. (Adam Rubinstein, MD, Miami Plastic Surgeon)

This is difficult problem to correct because to bring the nipple down you will end up needing to place a scar above the nipple to bring it down. The scar may be less visible than the nipple peeping through the bra, but it is an issue. Other phenomena that happens more commonly is the nipple appears high in relation to the breast because the breast has “bottomed out.”

If this the problem and not the actual placement of the nipple then the implant can be brought up by a technique called internal mastopexy or lifting the breast through internal sutures. (Usha Rajagopal, MD, San Francisco Plastic Surgeon)

Breast augmentation is the most popular cosmetic surgery in the United States because it can consistently change the breast of a woman and create a beautiful result. This surgery can commonly be done with a breast lift. If your nipple and areola are in too high a position, it is possible that the base of your breast implants may also be a little low. Your best bet is to work with a board-certified plastic surgeon who has a great deal of experience with breast augmentation and breast lift surgery.

They will be able to assess your breast and determine if the implant is in the correct position and then if the areola is in a good position relative to the breast mound. They may recommend a revision to change the position of the breast implant or to revise the breast lift so as to modify the position and shape of the areola. To learn more about breast augmentation, see photos, and help you decide which one is best for you, please visit us at the link below. (Pat Pazmino, MD, Miami Plastic Surgeon)

If an areola is placed too high after a mastopexy, it can be moved down but requires an incision above the areola. This brings into play the quandery as to which is the bigger aesthetic problem, the scar or the areolar position. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)

Correcting high nipple/areola after breast lift with implants

The usual cause of a high nipple/areola after breast lift with implants is a low implant – making the nipple/areola appear above the center of the breast (implant). Correction is done from within to raise the implant.

Sometimes, the lower skin at the bottom of the breast is removed to help hold the implant up. If your nipple/areola were really placed too high at the beginning, then the treatment is not as easy or predictable. Your plastic surgeon can evaluate you and recommend what you need. (Randy J. Buckspan, MD, Austin Plastic Surgeon)

Correcting high implants

Correcting high implants are much harder to do than raising them if they area too low. WIthout seeing you in consultation it would be difficutl to tell. Breast lifts with implants can do that sometimes. (Steven Wallach, MD, Manhattan Plastic Surgeon)

If your implants have settled too much, this will make your nipples appear to be too high on your breast mounds. This can be improved by repositioning your implants by adjusting the implant pockets. If your implants are appropriately positioned on your chest wall, then usually the height of the nipples can be reduced by excising some skin in the inframammary creases (the creases below the breasts).

This reduces the distance from the creases to the bottom of the areolae and helps center the nipple/areola complexes more appropriately on the breast mounds. It is possible that you already have scars in these areas from your prior lift. Your plastic surgeon can discuss options with you after he or she has examined you. (Michael D. Yates, MD, Huntsville Plastic Surgeon)

Correcting high nipples

Assuming that your nipples were not high to begin with, it might be that your implants are sitting too low. This can be corrected by using two or three layers of sutures inside of the breast implant pocket to re-build the crease under your breast to a higher level.

The result of this should be an elevation of the implants higher on the chest and a rotation of your nipples into a more central area on the breast mound. It is possible to decrease the diameter of your areola at the same time. (Edwin C. Pound, III, MD, Atlanta Plastic Surgeon)

Unfortunately there is no easy solution to this problem. If the areola is too high, there is one way to lower it. That is to put in a tissue expander and expand the skin above the areola. The extra skin can then be used to lower the position of the areola. Patients do not want this procedure as the tissue expander is very obvious, cannot be disguised and is quite strange looking. The best solution is to select your clothes and bras carefully. Repositioning the implants can change the relationship of the nipple to the breast mound but will not address the issue of the areola skin being visible above your clothing. I am sorry there is no other excellent solution. (Tracy Pfeifer, MD, Manhattan Plastic Surgeon)

Not easy to correct overly elevated nipples

An overly elevated nipple/areola after breast lift surgery with or without implants is not uncommon and can be related to placing the nipple/areola to high and to the inevitability of descent / “bottoming out” of the breast with time due to gravity and tissue stretching.

The nipple/areola position cannot be lowered effectively, but the lower breast can be repositioned higher on the chest wall to improve the balance such that the nipple/areola is better centered at or near the central portion and apex of the breast mound, rather than well above the center as can occur with time. Unfortunately, despite these efforts to revise the breast, the same problem can occur again. (David J. Levens, MD, Coral Springs Plastic Surgeon)

There are two reasons why nipple position can look high after breast augmentation and lift. First, and fortunately less common, the nipple was actually placed too high when the lift was performed. If this is the case, the nipple has to be lowered, and you will have a vertical scar above the nipple (where it was lowered from).

The other cause, which is more common, is that the distance from the nipple to your breast fold is too long and the nipple is not at the center of the implant. This is called a “high-riding” nipple and can be corrected by repositioning the implant higher and reducing the distance from the nipple to the breast fold.

Unfortunately, both cases are technically challenging. See the video below for more on breast lifts. (Michael A. Jazayeri, MD, Santa Ana Plastic Surgeon)

Nipple too high after a breast lift

It is always easier to lift or raise your nipples, but lowering them without leaving a scar above them is a difficult problem. There are generally few solutions to the problem you describe of having your nipple too high after a breast lift or breast reduction, and none of them are an easy fix. The three options that are available is to have a scar above your nipple after you move it down, something that would show in low cut shirts, but it would not have a dark pigment like your nipple does. The second option is to raise the implant which will artificially lower the nipple. And the third option, which is much more aggressive and rarely done is to place tissue expanders and stretch the skin above your nipples. If you have any further questions, you can always shcedule a consultation at our office. (Ankit Desai, MD, Jacksonville Plastic Surgeon)

This can be better addressed with a photograph – having said that, if there is too much skin between the nipple-areola and the fold under the breast, this can be corrected by removing a segment of skin from the lower pole breast area or repositioning the implants higher or both. Good luck in addressing your concerns. (J. Vicente P. Poblete, MD, Cleveland Plastic Surgeon)